Book review of The Neuropsychiatry of Epilepsy. Edited by Michael Trimble and Bettina Schmitz (Cambridge,UK: Cambridge University Press, 2002). [Pp. 350]. ISBN 0521005167 (pbk). £39.95.

Bimanual co-ordination is a field that has generated much research interest. It is clear that when hands move simultaneously there is a tendency for such movements to be synchronized. This phenomenon has also been observed in individuals with congenital brain damage, such as cerebral palsy. This paper provides an overview of past and current work in the area of bimanual co-ordination looking at the nature of the coupling and the underlying control of such movements. Work on ‘non-disabled’ individuals and unimanual reaching and grasping is included, but the main emphasis is bimanual co-ordination in children with hemiparetic cerebral palsy. The direction for future research is discussed and consideration given to the therapeutic implications of such work.     

Target predictability influences the distribution of coordinated eye-head gaze saccades in patients with homonymous hemianopia

Abstract

In hemianopic patients target predictability plays a differential role for the distribution of different types of initial saccades. A linear correlation was shown to exist between the adaptive state of reading capability and the probability of a correct initial eye-head gaze saccade that hit the target accurately. A constant target frequency of 0.8 Hz was found to be the optimum frequency for hemianopic patients to follow square step targets with an eccentricity of ±20°. Variability of the compensatory eye movement velocity gain was lowest at this frequency. We were able to use this target frequency as a test for a clinical classification of the status of adaptation of hemianopic patients in combination with simple reading tests. The repetition of this manoeuvre could correct the synkinesis and the balance of the VOR during active gaze of hemianopic patients. [Neurol Res 1996; 18; 425-439]     

Services for children with developmental co-ordination disorder: an evaluation against best practice principles

Purpose: The National Health Service in Scotland published a best practice framework to support occupational therapists and physiotherapists to deliver effective services for children with developmental co-ordination disorder (DCD); however, adherence is variable. To highlight areas for development, this study compared the care pathway within a paediatric DCD service against the NHS Scotland framework. Methods: A partnership of researchers and clinicians based in the United Kingdom conducted a qualitative study with 37 participants (N?=?13 interview participants, N?=?24 workshop participants). In-depth interviews and/or workshops were used to map the DCD service against the NHS framework. Identified gaps were aligned with four key stages of the care pathway. Qualitative analysis software was used to analyse the data. Results: Core principles to guide future development were identified for each phase of the pathway. These core principles related to the NHS framework and focused on issues such as involving the family, defining clear pathways and enhancing children’s participation. Participants identified potential strategies for service improvement such as developing community-based interventions and information provision. Conclusion: Challenges when providing services for children with DCD include confusing service pathways and poor partnership working. It is, therefore, important that clinicians utilise collaborative working strategies that support children’s participation.

• Implications for Rehabilitation

• There are numerous challenges related to the implementation of best practice principles into the provision of therapy services for children with developmental coordination disorder (DCD).

• It is important that AHPs seek ways of engaging parents and educational professionals at all stages of the care pathway in order to ensure optimum service provision for the child.

• Addressing participation is an important aspect and community-based strategies may be particularly beneficial, both as a preventative activity and as an intervention approach.

     

省级中医药数据中心建设现状分析及发展对策研究

以31家省级中医药数据中心建设管理人员为研究对象并采集数据,从组织管理和人员、软硬件建设和应用等方面阐述数据中心信息化建设与应用现状,分析存在问题并提出建议,包括完善组织管理体系、加强专业人才培养、加大经费投入力度、制定互联互通接口开放规范。     

吉林省新型农村合作医疗“住院低比例报销起付段”措施实施效果分析

目的:总结吉林省新型农村合作医疗制度经验,分析实行"住院低比例报销起付段"对住院率的影响,为全国新型农村合作医疗制度有效运行提供参考和借鉴。方法:采用分层抽样方法抽取13个样本县,对省、县、乡三级医疗卫生机构进行现场调查和数据搜集。结果:新型农村合作医疗门诊统筹与住院低比例报销起付段的结合,有效抑制了住院率的增长,合理调整了县乡两级医疗机构的就医结构,适度规避了"门诊转住院"风险。结论:住院低比例报销起付段新举措的实施具有积极意义,但在推广的过程中也应注意因地制宜和基金风险。     

基于省级平台的临床路径知识库共享平台设计

提出了一种基于省级平台的临床路径知识库共享系统的设计方案,主要从系统整体架构设计、网络结构设计、功能规划以及系统业务流程设计几个方面进行了分析.构架基于省级平台的临床知识库共享平台,可以将过去仅在单一医院内使用的临床路径分享给所有医院,真正意义上实现数据互通,数据共享.同时,临床路径知识共享系统与省外医疗信息平台实现对接.     

骨不连治疗的研究与技术应用进展*

背景：骨不连是骨折晚期常见的临床问题，数十年来，在各种新式内外固定材料、普及的显微外科技术、创新的植骨材料，尤其是分子生物学技术的全面帮助下，骨不连的治疗取得了突破性进展。
　　目的：总结骨不连治疗的研究进展，为以后更好地治疗骨不连提供技术理论和方法选择。
　　方法：由第一作者运用计算机检索系统检索1990年1月至2013年5月发表的有关骨不连原因及治疗方法的文献，以“fracture nonunion，treatment，progress”或“骨不连，治疗方法，进展”为检索词。同一领域则选择近期发表或者发表在权威杂志的文章。
　　结果与结论：排除重复性研究及时间跨度大的文献，从检索结果中共选择了48篇文章进一步分析。骨不连治疗手段主要有两种：非手术方式和手术方式，目前临床上以手术方式为主且高效。骨折愈合是多环节参与的复杂过程，一旦骨不连发生，应具体问题具体分析，根据患者的实际情况采取个体化治疗原则，重视软组织的保护，必要时联合运用多种手术及非手术方法，才能取得满意的疗效。     

以人为本 以才兴业 为食品药品科学检验提供人才支撑

目的 加强人才队伍建设，推动科学检验工作。方法 分析省级食品药品检验机构人才队伍的现状，介绍陕西省食品药品检验所通过选才、育才、聚才等一系列举措，加强人才队伍建设的具体实践。结果与结论 通过加快推进事业单位人事制度改革，进一步健全培养机制，强化培养措施，为科学检验提供有力的人才支撑。     

骨形态发生蛋白2信号通路与骨发生发育及损伤修复

背景：骨形态发生蛋白在骨形成过程中、骨折愈合后以及骨质破坏后骨诱导方面起着重要作用,它可以作为启动调节因子和别的信号通路共同促进新骨形成。内源性骨形态发生蛋白2的调节可以作为未来骨修复领域的一个新的靶点。 目的：通过分析和总结1988年以来骨形态发生蛋白信号传导通路在软骨内成骨、维持成人骨骼生长发育中的作用机制,探索骨形态发生蛋白信号通路在骨的发育以及损伤修复中的作用。 方法：分别以“骨形态发生蛋白、软骨内成骨、骨修复”,“bone  reduction”为检索词,应用计算机检索重庆维普(VIP)期刊全文数据库及PubMed 数据库1998年1月至2009年12月有关文章。纳入有关骨形态发生蛋白信号通路及其作用的文献。排除与研究目的无关和内容重复者。保留34篇文献做进一步分析。 结果与结论：骨形态发生蛋白信号通路诱导骨再生潜能在脊柱外科手术、骨折后愈合以及骨破坏后骨诱导等诸多领域成为研究热点。在骨形成过程中,骨形态发生蛋白也作为启动调节因子和别的信号通路相互影响共同促进新骨形成,出生后,骨形态发生蛋白也参与骨骼动态平衡的维持。在骨的微环境中,骨形态发生蛋白和其他影响骨质动态平衡的信号通路共同为诱导骨形成的合成代谢疗法提供了一个新靶点,这为骨修复时骨形态发生蛋白控制新骨的形成提供了一个新的思路。